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Reaching The Unreached: COVID-19 Vaccinations In Jumla

reflect on the rollout of COVID-19 vaccinations in Jumla
District in Nepal’s far-western region, and the role of
the cold chain – strengthened with support from UNICEF and
partners – in bringing vaccines to remote


28 March

Jumla, Nepal: Nanda Lal Rawat
has spent his entire life in remote Kankasundari in Jumla
District in Nepal’s far-western region. And he’s not the
first in his family to have done so.

Nepal/2021/LPNgakhusi Healthworker Nanda Lal Rawat on the
premises the Malikabota Health Post in Kankasundari Rural
Municipality, Jumla

have been here for so many generations, I couldn’t tell
you how far back it goes,” he

Such a deep-rooted connection
to this place and its people was a big part of what had led
him to become a healthworker. Today, he is the in-charge at
the Malikabota Health Post in Kankasundari, where he works
with his team to provide essential health services to the

That role became all the more important
when the COVID-19 pandemic began its spread around the
country in early 2020. Although Kankasundari’s geographic
isolation initially appeared to work to its advantage,
limiting as it did foot traffic from outside, the
possibility – and the fear – of an outbreak was always
there, particularly as community members who were working in
countries like India began to head back

“There was so much uncertainty
at the time about the disease, with all kinds of rumours
going around, creating panic and anxiety,” Nanda

He and his team worked to allay
these fears and concerns as far as they could with the
information they had, and kept up maximum vigilance towards
new arrivals.

Fortunately, Kankasundari has so far
been spared the brunt of the pandemic – not a single case
of COVID-19 has been seen in the area. Still, Nanda says
it’s important not to be complacent. “We know that if an
outbreak happens here, it will be very difficult to
contain,” he says.

And so, when the Government of
Nepal launched the vaccination campaign in late January this
year, with healthworkers given first priority, Nanda’s
relief and pride knew no

“Being put in the first
priority group made me feel like our efforts and sacrifices
as healthworkers was being recognized,” he says. “I felt
very validated.”


Having gotten
vaccinated himself, Nanda was eager to see vaccines reach
the community. On 7 March, the second phase of the campaign
began, targeting elderly persons over the age of 65. With
this, Nanda and his team leapt immediately into action,
pushing out PSAs through loudspeakers, mobilizing female
community health volunteers to go door to door with
messages, even calling eligible senior citizens on the phone
to urge them to come get the vaccine.

One of these was
81-year-old Chaitee Rawat.

very excited to go get the shot,” she said, as she got
ready to head out to the health post, “Why wouldn’t I be
happy to get the vaccine?”

Over the
two days that vaccinations ran for at the facility, 120
elderly people from the community like Chaitee arrived to
get inoculated.

“It was great to see
that our efforts to communicate with them and convince them
had not gone in vain,” Nanda


an effective cold chain

The delivery of vaccines to
remote places like Kankasundari relies on an effective
‘cold chain’, which refers to a series of coordinated
events in temperature-controlled environments to store,
manage and transport vaccines. Ever since the beginning of
routine immunization efforts in Nepal, UNICEF together with
global health partners like Gavi have been supporting the
Government of Nepal to assess, expand and strengthen its
cold chain capacity, so that children and families around
the country can have access to life-saving

Nepal/2021/LPNgakhusiUNICEF staff and health officials
receiving COVID-19 vaccines at the Jumla
Nepal/2021/LPNgakhusiHealth officials at the Jumla
District Vaccine Store unpacking auto-disable syringes
provided by UNICEF for use in the COVID-19 vaccination

As part of UNICEF’s
support – which also includes technical and logistical
backing – cold rooms and vaccine refrigerators have been
installed at different facilities at the federal, provincial
and local levels, and vaccine cold boxes and carriers
provided for safe transportation to vaccination sites. In
2020 alone, UNICEF installed 290 pieces of cold chain
equipment in different facilities nationwide. Plans are also
in place to procure and install an additional 910 pieces to
address still-existing gaps in select areas. All these
efforts are now proving critical to the roll-out of COVID-19
vaccination campaign.

Nepal/2021/LPNgakhusiPorters carry COVID-19 vaccines to
the Malikabota Health Post in Jumla
Nepal/2021/LPNgakhusiPorters carrying COVID-19 vaccines
across a bridge en route to a health facility in Jumla
Nepal/2021/LPNgakhusiAuxiliary nurse midwife Ganga
Devkota unpacks COVID-19 vaccines at the Malikabota Health
Post in Kankasundari, Jumla

the difficult terrain in this part of the country, it’s a
long process to bring vaccines in; it takes days of travel
by air, by road, and in some places by foot,” says Indra
Kala Tamang, Health Officer at UNICEF

Indeed, before reaching
Kankasundari, the vaccines were first transported to the
provincial vaccine store in Nepalgunj from Kathmandu, then
flown to Jumla airport. They were then dispatched via road
to the district vaccine store, then onto the sub-store at
Pandugufa – both facilities equipped with refrigeration
units installed by UNICEF – before being packed into cold
boxes and carried to the Malikabota Health Post on the backs
of porters.

Nepal/2021/LPNgakhusiUNICEF Nepal Health Officer Indra
Kala Tamang

“It’s truly
gratifying to see how UNICEF’s support to the cold chain
at different levels is being used in this vaccine drive to
reach far-flung communities,” Indra Kala

That very same cold chain will also be used
to store, transport and distribute vaccines
received through the COVAX Facility, a partnership between
, made possible through
generous donor support from governments, international
organizations, foundations and the private sector. Nepal
received its first consignment of COVID-19 vaccines – a
total of 348,000 doses – that were shipped through the COVAX
facility on 7 March 2021, in support of the Government of
Nepal’s nation-wide vaccination

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